Haiti After the Earthquake (11 page)

The two leaders then left the room to deliver a grim set of public declarations at the official UN session. It was my job to sit behind President Clinton as his “plus one” (a term I'd never heard before
2009). He gave a brief statement that acknowledged the UNʹs losses but put the emphasis on the huge toll taken—we didn't have numbers, but it was clearly many thousands—on the Haitian government and civilian population. Pained but confident, Clinton struck a note respectful to the Haitians and apposite to the UN setting:

On January 13, Clinton's mix of idealism and pragmatism buoyed me. He had dealt with natural disasters before: he spearheaded recovery efforts for the 2004 tsunami and for Hurricane Katrina, and had called for more help for Haiti after the storms of 2008. Then, too, he'd pushed for immediate rescue and relief followed by a massive reconstruction response. But were these disasters of comparable magnitude? We had no idea, just then, but it couldn't hurt to have an experienced hand on deck.

This hope sustained me in the early hours before we had any sense of the body count. Good intel depended on reliable sources, and there were few of those on day two. When Clinton was asked whether estimates of one hundred thousand dead were off the mark, he responded, “They do seem high. If you think about the population of Port-au-Prince and the surrounding area, in excess of two million, one hundred thousand would be about 5 percent. What I am hoping is that, when they clear the rubble away, they will find that more people have survived these collapsing buildings than they think. We just don't know.”
⁵

Looking back, it's apparent that the rubble will take years to clear away and that the toll was far greater than feared. But on January 13, we didn't grasp the size of the disaster nor did we anticipate the magnitude of the relief efforts that would follow. Still, every report coming out of Haiti suggested that it was worse, far worse, than anything that had happened there before. Few Haitians were present at the UN meeting. Leslie Voltaire (also required to speak) was dazed, as I was. He still didn't know if his son was alive, and I still had no idea what had become of my in-laws, students, coworkers, and friends. Neither of us was sure that we were in the right place that day.

Thus began, well before the end of day two, the making of grim lists. In those first hours, Haitian families and their friends and colleagues kept lists, mental or otherwise, of those unaccounted for. The lists grew shorter with the hours, as searches and queries turned up the living and the dead. It was the living I wanted to help directly—that's why I felt out of place on the UN dais sitting behind President Clinton. At least Voltaire and the others were real diplomats. But what was I doing sitting in a meeting when medical needs were great? (Or was my ardent desire to show up in Haiti merely a symptom of some misguided personal quest for efficacy?)

Ill at ease listening to declarations in the UN general assembly, I knew I needed to get to Haiti immediately. There had to be a way, even though the airport had been damaged and was closed to all commercial traffic. Claire Pierre caught a train to New York to join me; she too wanted to return to Haiti, which was a great relief to me (and to her mother, who had spent the night after the quake on the lawn of the Prime Minister's office, along with hundreds of others). Voltaire wanted to go, too, and Clinton was ready to join us, he said, “as soon as I know I won't be in the way.”

It took a dozen phone calls and Secretary Clinton's help, but by the end of the next day we boarded a small private jet headed for Haiti. On the plane was precisely the sort of team Dr. Alix Lassègue had requested: two orthopedic surgeons (a father-daughter team) and others able to take care of the critically injured, including a Haitian-American ICU doctor from New York. Flying to Port-au-Prince
from New York takes only three or four hours, but for about an hour, our plane circled the city. Smothered by near-total darkness, the only sources of light were small fires dotting the vast conurbation of Port-au-Prince.

I've lost track of the times I've flown into Haiti, sometimes during political violence and sometimes during disasters natural and unnatural. But I'd never arrived with a heavier heart than on that day. As soon as we opened the door, it hit us: a charnel-house stench filled the air of the windswept runway. I knew this smell but never imagined I would encounter it in an open space. Now it hung over the city like a filthy, clinging garment—the stench of a battlefield without the violence or din of war. Except for airplanes and helicopters, there was silence.

Loune Viaud and Nancy Dorsinville were there, as was the reporter Byron Pitts—he'd done a
60 Minutes
piece on our work in central Haiti and had become a friend. Pitts had flown to the Dominican Republic and hired a car to take him to Port-au-Prince. Although I felt entirely unprepared to speak on camera, Pitts was about the only journalist I was glad to see. We'd come with surgeons and medical supplies, and were headed for the General Hospital. Pitts and his team would meet us there, and I promised to sit down with him later that night. (It was already ten o'clock.) But first I went to the nearby UN logistics base, where my colleagues had cobbled together a makeshift field hospital under a tent and were attending to a number of survivors. I saw them—David Walton, Joia Mukherjee, and Louise Ivers—coming from rounds. David and Joia had flown to the Dominican Republic and come into Haiti by road, but Louise had been right in the middle of it all since the earthquake. She hadn't slept more than a few hours in the previous two days, and was signing out patients and duties to Haitian and American colleagues.

When the quake hit, Louise had been in a meeting about, of all things, food security and disaster preparedness. Ounsel Médé—pronounced “Mayday”—had driven her there, and a wall had fallen on the jeep, crushing the passenger side and taking out the windshield. Médé was uninjured but shaken. Louise found herself the only doctor amidst a sea of pain and suffering. But even the best doctors
are impotent without the tools of our trade. Her description of the immediate aftermath says a lot about trying to provide care without proper equipment:

I didn't know these details when I landed but had a good sense by then of what my colleagues had gone through. It was a relief to see them—my protégés in the deepest sense of the word—and I embraced them all, especially Louise. Few words were spoken, but I was flooded with gratitude for her presence. I could tell that she was tired. But after eight years in Haiti, she was as committed to its people as a doctor could be.

I wanted to share the burden of caring for the patients streaming into Haiti's crippled hospitals. Late that night, in two waves, we made our way to Port-au-Prince's largest health care facility, where Dr. Lassègue (and Bryon Pitts and God knows what else) awaited us. I still had little idea of what to expect, and wanted most of all to confer privately with two of my closest friends, Loune and Nancy. Now we were together at last, alone in a jeep with Samuel, a driver we knew well, and en route to the General Hospital.

We had been through rough times before: political strife, coups, the loss of many friends and coworkers. (Loune and I had worked together for more than twenty years; she is one of the toughest people I know.) Loune and Nancy tried talking, though not much came out. They had both been in the Global Fund meeting along with Prime Minister Bellerive and many of our colleagues. They didn't say much about their experience because the building had not collapsed immediately upon them, and they knew how many others had not been so
lucky. But the ceiling had started to crack, and they heard another part of the building come tumbling down. Several voices cried out, and one of our friends fainted dead away, they said. But most in the crowded room did not panic; they gathered their affairs, helped their colleague to her feet, and filed into an open courtyard. Outside, a strange cloud of white dust picked up the late-afternoon light as Loune and Nancy moved to safer ground.

The street around them slowly filled with dazed people, many of them reaching for cell phones. As hundreds of thousands of people all tried at once to call friends and loved ones, overtaxed and damaged switching stations gave way. The city's residents were cut off from the world. The Prime Minister and other officials got a sense of what had happened—it took some minutes to understand it had been a quake, not a bomb—and sped off towards the city center. I'd gathered that much of the story from Bellerive shortly after the quake.

As we headed towards the General Hospital Loune and Nancy filled in some of the blanks about the first hours after the quake. In the busy neighborhood of Delmas, where the AIDS meeting had taken place, they could only guess the scope of the destruction. Power poles were skewed at strange angles or fallen, and a number of houses and commercial buildings, including some of the country's larger banks, had collapsed; other structures right next to them had not. It was rush hour, and confusion was welling, but many of Haiti's famously colorful tap-taps—the local equivalent of public transport—had pulled over as if their drivers awaited some harsher blow. Some cars and vehicles were crushed or damaged (like Médé's) by collapsed buildings and walls, but most stalled on Delmas's broad boulevard, as drivers tried to figure out what had happened.

Soon, confusion reigned. Something bad had happened; that was given and even expected in Haiti. But no one in Delmas or even in more heavily damaged parts of town knew how bad. As the news spread and as dusk fell, the city, then the nation, began keeping personal tallies. Loune and Nancy reassured me that my own relatives were alive and accounted for. But throughout the country, and then the diaspora, it was the week of grim lists.

Although I'd forgotten to ask, I later learned that at the top of Loune and Nancy's list were the almost fifty unaccompanied minors in the General Hospital: children with disabilities who had been born or treated in the hospital and whose parents had, before the quake, died or been unable to care for them. For more than two months, we'd been scouting neighborhoods north of the city for a safe haven where we could move them. But such matters take time, ample resources, and the blessing of the child-welfare system. We didn't want to bring the children to one of the many mediocre orphanages dotting the Haitian landscape; we wanted to find the right setting and the medical expertise these children needed. By January, Loune had found a few properties she thought might work as a home for special-needs kids of all ages, and she and Nancy and others had promised to take all the children into our care.

On the twelfth, as the sun set over the crippled city, the dimensions of the tragedy had not begun to sink in. But Loune and Nancy felt their first priority was checking on these children. As they made their way to the General Hospital, they saw, as everyone did, the wounded and the dead and the simply dazed. The way into the city center was obstructed by downed buildings and flattened vehicles and utility poles, but my friends pressed on. When they reached the hospital, they found chaos. Many employees not injured or killed had left their posts to search for family members; more and more casualties were arriving at the gates.

The dead were everywhere, but they discovered that not one of the handicapped children had been injured. (They were shifted to the “safe and accounted-for” list.) Staff moved the children into the open courtyard, where for two days they shared a crowded and foul space with the dead and wounded. The day before my arrival, Loune found safer lodging for them at an undamaged hospital run by a friend, a physician-priest. (Loune would later find a proper home for all of these children, whose number would grow to fifty-three.)

If Loune and Nancy recounted this part of the story as we headed to the hospital, it didn't register. What I do recall was that their accounts were interrupted by long silences. I didn't press them for details. Both were in anguish as we traveled through the ruined city
they called home. It was my first look at it, and there was little to say. The headlights from our vehicle penetrated the darkness, which was complete save some scattered fires, thousands of candles, and the alien glow of helicopters of unknown provenance. Everywhere buildings spilled into the streets. Most commonly, concrete slabs—the buildings' floors—were pancaked down upon themselves, and it was from these buildings that the smell of death emanated. Some structures leaned over the streets, held in place at menacing angles by twisted steel.

We surveyed the wreckage while moving slowly through narrow openings. It was a transformed landscape, strewn with the ruins of some recognizable landmarks. We reached the densely populated area known as Bourdon. As a student in the eighties, I had spent many weekends with the Lafontants in a house on Martin Luther King Avenue, the main street from the airport to the center of town. To my left and right were scores of similar houses and also small businesses—many now stacks of floors with little more than a foot or two between them. At 5:00 P.M., businesses and homes and schools would have been full. Although we still had no idea of the death toll, it seemed unlikely that many would be pulled from this rubble alive.